Literature Review

The Private-Equity Deal That Flattened a Hospital Chain and Its LandlordWall Street Journal; by Jonathan WeilFollow; 5/7/24Cerberus made a big profit, but Steward went bankrupt and its landlord suffered big losses. In the spring of 2020, Cerberus Capital Management was faced with a tricky financial situation. It owned a struggling hospital chain that needed $400 million to dig out of a deep financial hole, but Cerberus wanted to sell rather than invest more. The deal helped shape much of what followed for Steward Health Care System over the next four years, culminating this week in the Chapter 11 filing of Steward, one of the biggest hospital bankruptcies in U.S. history. ... The 2020 deal paved the way for Cerberus to sell its majority stake in Steward to the hospital chain’s chief executive and others and lock in an eventual $800 million profit. It bought time for the CEO and new majority owner, Dr. Ralph de la Torre, who received a big cash payout himself the next year.

Hospitals Are Refusing to Do Surgeries Unless You Pay in Full FirstWall Street Journal; by Melanie Evans; 5/9/24Now, more hospitals and surgery centers are demanding patients pay in advance. Advance billing helps the facilities avoid hounding patients to settle up. Yet it is distressing patients who must come up with thousands of dollars while struggling with serious conditions. Heather Miconi has seven weeks to come up with $2,000 to pay for surgery her daughter needs to breathe more easily. Merritt Island Surgery Center in Merritt Island, Fla., billed Miconi in advance of the adenoid and tonsil surgery. If she can’t pay for the surgery before it is scheduled to take place next month, the procedure will be put off. Miconi, whose insurance won’t cover the cost because she has a high deductible, works three jobs and doesn’t have savings to cover the cost. She is now appealing to strangers through a GoFundMe campaign for help. For years, hospitals and surgery centers waited to perform procedures before sending bills to patients. That often left them chasing after patients for payment, repeatedly sending invoices and enlisting debt collectors. Those who can’t come up with the sums have been forced to put off procedures. Some who paid up discovered later they were overcharged, then had to fight for refunds. Among the procedures that hospitals and surgery centers are seeking prepayments for are knee replacements, CT scans and births.

End of life outcomes following Comfort Care Orders: A single center experience The American Journal of Hospice & Palliative Care; by Matthew Tucker, Dayna Hovern, John Liantonion, Elizabeth Collins, Adam F Binder; 5/13/24 Conclusions: The majority of patients placed on comfort care died during their hospitalization demonstrating a real need for comprehensive end of life care and immediate hospice services. For those discharged with hospice services, they spent an excessive amount of time in the hospital waiting for services to be arranged.

Highmark Health lays off dozens of employees Modern Healthcare; by Lauren Berryman; 5/8/24Highmark Health has laid off 47 employees in its latest round of job cuts. The Pittsburgh-headquartered organization owns Highmark Inc., which provides health insurance plans to 6.9 million policyholders in Pennsylvania, West Virginia, Delaware and New York. It also operates Allegheny Health Network, which comprises 14 hospitals. A Highmark spokesperson declined to answer questions about the types of roles or specific locations affected. ... The most recent layoffs, which were first reported by news outlet PennLive Tuesday, follow the 182 jobs Highmark eliminated in March. The organization has laid off at least 229 employees so far in 2024.

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.

HCA accused of withholding pay of 1,000 workersBecker's Hospital Review; by Kelly Gooch; 5/6/24 HCA Healthcare faces a lawsuit alleging its Asheville, N.C.-based Mission Health illegally kept pay from at least 1,000 employees, the Citizen Times reported May 6. Sharon McRee — who said she worked as a nonexempt, hourly respiratory therapist at Mission from July 2002 through its 2019 acquisition by Nashville, Tenn.-based HCA before leaving in July 2022 — alleges she and approximately 1,000 or more employees "clocked in as required and performed the principal activities of their jobs," but their employer "generally did not pay them for all of their time worked," according to the lawsuit, which was accessed by Becker's.

He Thinks His Wife Died in an Understaffed Hospital. Now He’s Trying to Change the Industry.Fortune; by KFF Health News and Kate Wells; 4/19/24For the past year, police Detective Tim Lillard has spent most of his waking hours unofficially investigating his wife’s death. The question has never been exactly how Ann Picha-Lillard died on Nov. 19, 2022: She succumbed to respiratory failure after an infection put too much strain on her weakened lungs. She was 65. For Tim Lillard, the question has been why.Publisher's note: We often discuss workforce shortages in terms of staff stress. This interesting and heartbreaking story explores workforce shortages in terms of patient harm.

Steward files for bankruptcyBecker's Hospital CFO Report; by Laura Dyrda; 5/6/24Dallas, Texas-based Steward Health Care filed for Chapter 11 bankruptcy and will receive millions in financing from Medical Properties Trust to maintain operations at existing hospitals and clinics, according to a May 6 health system news release. The 30 hospitals in the Steward network will continue patient care during the bankruptcy proceedings, and the physician-led health system does not expect interruptions to daily operations. ... The for-profit health system has faced financial challenges and liquidity issues in recent months, blaming low reimbursement from government payers and increasing costs for labor, materials and operations due to inflation. The system also reported continuing to experience negative financial effects from the COVID-19 pandemic.

Star ratings of Leapfrog's 25 straight-'A' and 'F' hospitals Becker's Hospital Review; by Mackenzie Bean; updated 5/3/24 A comparison of data from CMS and The Leapfrog Group suggests that a hospital's strong performance in one national quality rating system does not necessarily mean it will be a top performer in another. Leapfrog updated its spring safety grades May 1, recognizing 15 hospitals that have received an "A" grade in every consecutive update since 2012. Of these hospitals, only eight received a five-star rating from CMS. Similar discrepancies are seen across Leapfrog's "F" hospitals. While two did receive one star — the lowest possible rating — another five received two stars, and one hospital earned four stars. [Click on the title's link for the list.]

Stranded in the ER, seniors await hospital care and suffer avoidable harm KFF Health News; by Judith Graham; 5/6/24 Every day, the scene plays out in hospitals across America: Older men and women lie on gurneys in emergency room corridors moaning or suffering silently as harried medical staff attend to crises. Even when physicians determine these patients need to be admitted to the hospital, they often wait for hours — sometimes more than a day — in the ER in pain and discomfort, not getting enough food or water, not moving around, not being helped to the bathroom, and not getting the kind of care doctors deem necessary.

Noncompete ban may squeeze rural hospitals, report shows Modern Healthcare; by Alex Kacik; 5/2/24 The federal noncompete ban may squeeze rural nonprofit hospitals that continue to see labor costs rise, a new report shows. Last week, the Federal Trade Commission voted to finalize a rule preventing most employers from enforcing or issuing contracts that restrict employees from working for a competitor. ... Larger hospitals are more likely to have the financial flexibility to offer clinicians and staff higher wages, likely at the expense of smaller, rural hospitals, Fitch Senior Director Kevin Holloran said.

Tenet adds 45 ASCs, sells 9 hospitals in Q1Becker's Hospital CFO Report; by Alan Condon; 5/1/24 In the first quarter, Dallas-based Tenet Healthcare sold nine hospitals while its outpatient business United Surgical International Partners acquired 45 ambulatory surgery centers and added 32 service lines. Tenet has increased the number of ASCs in its portfolio to 512 and decreased the number of hospitals it operates to 49, highlighting the company's expectation that its ASC business will drive long-term growth as care continues to shift from inpatient to outpatient settings. Tenet posted a net income of $2.2 billion in the first quarter — up from $143 million in the same period last year — and aims to spend about $250 million a year on ASC mergers and acquisitions. 

Transitional Bridges offers compassionate alternative to plastic belongings bagsABC 8 News, Richmond, VA; by EIN Presswire; 4/30/24Transitional Bridges, a San Diego-based nonprofit focused on inspiring compassion and improving end-of-life care through art, has created Transitional Belongings Bags, a compassionate and eco-friendly alternative to the plastic bags hospitals use to hand over belongings to loved ones after a patient has died. The concept was first introduced 17 years ago by the Irish Hospice Foundation Hospice Friendly Hospitals Program to promote dignity and sensitivity when returning a loved one’s possessions to bereaved family and friends. ... Lorene Morris, the founder and president of Transitional Bridges, became inspired to bring the movement to the U.S. after her mother, an artist, died unexpectedly from postoperative complications. When the family was handed their mother's possessions in two large, clear plastic bags, Morris recalls, “I felt like the whole world could see those intimate items. It was just so wrong.”